DENTAL CARE

Q: A:You Have A Large Infection (Part II) Last week, we discussed a tooth that had an issue but went away. To refresh everyone’s memory, the patient in question had horrible pain on a tooth. After localizing the tooth, I performed a root canal procedure for the patent, and he felt much better. The keyword is “much,” not “totally.” He complained off and on about a vague sensitivity in the area. Slight discomfort on occasion may happen following a root canal procedure. The typical course of events that occurs is the total resolution of the problem. It seems that the body just needs time to heal. In our case, complete comfort ensued, and all was well. All was well until this year when I received another phone call. My patient told me that this tooth broke, and this fracture interfered with his ability to eat. Upon examining the tooth, I saw the break in the tooth occurred right through the area of the nerve of the tooth. My patient had no sensation of feeling from the exposed nerve of the tooth. The nerve of the tooth transmits feelings to the brain. Extremes in hot or cold will not feel pleasant. In our case, there was no feeling. The reason for the lack of sensation was because the nerve was gone. Let me clarify this point. The break went right through the place of the nerve. I need to emphasize that it went through the “place” of the nerve, but the nerve was not there.

Let’s talk about why the nerve wasn’t there. The off and on slight irritation of the previous year was due to a diseased nerve in the tooth. Maybe the tooth had some type of microfracture that was not visible. Perhaps the patient was a powerful grinder. Maybe he bit down on a hard pit. We could theorize forever. The underlying theme of all of our conjectures was that the tooth sustained some type of trauma, which resulted in damage from which it could not recover. The question remains as to what does trauma has to do with the infection that showed up a year later. The trauma is what causes the tooth to get sick. Teeth, due to their inadequate blood supply, do not recover well. The injured tooth gets inflamed, as evidenced by the sensitivity to heat or cold or even touch. If this lingers for a long time, then a severe toothache will be the result. If the inflammation progresses quickly, then the result will be the death of the tooth. If the tooth is dead, there is no longer any temperature or other sensitivity present. The quiet tooth has now lulled the patient into a false sense of security that everything is okay.

As the tooth dies, the dying process causes a release of toxic products. These leak out the root of the teeth and cause the infection that we see or ultimately feel with a swollen gum or face. The death of the tooth explains why the patient had no sensitivity when the tooth broke this year. It was a non-vital or dead tooth.

I found this case very interesting. I saved the tooth and cleared up the infection. My patient will have many years of excellent service from the tooth, and I removed an infection from his body. I am here for you if you need me as we plod along through this April. Don’t hesitate to call Megan at 440.951.7856 and ask to speak to me. I wish all of you good health and healthy spirits.